上斜肌麻痹的手术治疗

SURGICAL TREATMENT OF SUPERIOR OBLIQUE MUSCLE PARALYSIS

上斜肌麻痹可分为先天性(包括生后早期型)和后天性麻痹两型,前者多属眼肌先天性发育异常及产伤所致,后者多系外伤、流感、急性传染病所致,可用同视机、Parks法、Bielschowsky头低倾斜试验及Hess屏等检查确诊。根据上斜肌麻痹的程度,除轻度可配戴三棱镜矫正外,手术首选下斜肌减弱,或/和患眼上直肌后徙,或/和健眼下直肌后徒术,疗效均较满意。本文还讨论了上斜肌麻痹的鉴别诊断和选择手术的原则和方法。

Congenital or early infantile paralysis of the superior oblique muscle is primarily caused by congenital anomaly of the ocular muscles or by birth trauma, while the acquired is mostly caused by trauma, influenza, or acute infection. The diagnosis was done by synoptophore examination, Park's three step test, Bielschowsky test and Hess screen. Except in mild paralysis, the angle of strabismus may be corrected with prism. The first chosen of operation to treat the palsy of the superior oblique is the inferior oblique attenuation or/and the inperior rectus attenuation in the other eye. The results of the operations were showed satisfactory. Meanwhile in this paper the differential diagnosis and the surgical principle of the operation were also discussed.